If mastectomy is the best way to treat your breast cancer or to lower your risk forit, you have important decisions to make about your missing breast(s).

Do nothingMany women don't feel the need to replace their breasts. Some small-breasted women, for example, don't consider mastectomy a significant physical change. Others feel radically altered by their cancer, and choose to embrace their flat chest as a way of acknowledging mastectomy and their post-cancer personas. Other women simply don't want to have any additional or unnecessary surgery. Many women who opt to forego reconstruction are happy using prostheses when they feel like it, or nothing at all.

Don't feel pressured by what others think you should do. Gather information, carefully consider your options, and do what feels right for you.

If you're considering reconstruction, you'll need to make five key decisions:1. Which procedure is right for you?Reconstruction can be performed in a variety of ways: with implants, your own natural tissue, or a combination of both. Each alternative can be accomplished in different ways and requires varying surgical skills, time in the operating room and length of recovery. All women are not candidates for all reconstruction methods. Knowing all your options and understanding the advantages and disadvantages of each one is the best way to decide for yourself which procedure (if any) is the right one for you. Read about implants and tissue flaps.

2. Who will perform your reconstruction?The best possible results come from choosing a skilled surgeon who is experienced with the technique you choose. Not all surgeons do all procedures, so it's important to understand your reconstructive options, decide which one is the best for you, and then select a surgeon who is adept at that procedure. You may decide to have your reconstruction completed locally, or travel to another city to a surgeon who specializes in the technique you prefer. Choose a plastic surgeon.

3. Will you alter your opposite breast (if you are having one breast removed)?If you are having a unilateral mastectomy, your remaining healthy breast can be lifted, reduced or augmented to better match your newly reconstructed breast. Be sure to understand what these optional procedures entail and what you can expect from them before you decide whether they are right for you.

4. Will your reconstruction be performed at the same time as your mastectomy or later?Most women who have mastectomy are candidates for immediate reconstruction, which is done while they are still under general anesthetic from mastectomy. Some women may need to postpone reconstruction until they complete radiation or chemotherapy (or both); others may decide to defer reconstruction for other reasons. Although immediate reconstruction has several advantages, breasts can be rebuilt at any time in the future, months or even years after mastectomy.

5. Will you have your nipples reconstructed and/or tattooed?Nipple reconstruction and subsequent tattooing are optional procedures. Some women feel that these procedures signal the end to the breast cancer experience while visually restoring their breasts to near natural appearance. Other women choose to either not have nipples reconstructed at all -- surgically created nipples have no sensation or response. Tattooing is also optional, whether it is done to add color to recreated nipples or to simulate nipples.